Five More Dems Say No to Health Care Bill

Five more House Democrats said Tuesday that they will vote against Senate health care legislation, which puts opponents of reform just 11 votes shy of the 216 needed to prevent President Obama from scoring a major victory on his top domestic priority.

It looks like all of them -- except one -- are ConservaDems from conservative districts, aligning themselves with the Republican caucus. Who's the one? Kucinich. He's the only one from the left who is willing to expose the POS Senate bill for what it is. Even my supposed committed-to-single-payer-advocate congressman is under the sway of Captain Nancy and her lieutenants. He will not get my vote in November.

enjoying a 3,000% (yes, thousand percent) reduction in health insurance costs and giving big raises to their employees, it was impossible for him to stick with his "no"....he may have been bombarded with emails from his constituents telling him to vote YAY after Obama gave them that news in his sales speech.

(If he does) isn't going to change the dynamics one bit. Those voting against the bill are already getting ripped by the WH. Displeasing Dennis carried no risk at all for the no voters.

As for the political cover argument, 'if Dennis votes for it, I can do', equally specious. Those voting against the bill are trying to keep their seats and clearly they've heard from their constituents.

Deem and pass is being roundly criticized and seems less likely to occur than it did a day or so ago. Floating an anchor like this at this crucial stage suggests real desperation from Pelosi. The non-event of President Failure appearing on Fox is being characterized as 'I surrender'. Tingling with anticipation? Few are.

The dog that is no longer barking and hasn't for a good long while, is the 'the president is being held hostage by his advisors' meme. Nobody anywhere is suggesting that Obama wants anything more than a scrap of tissue he can wave and call a political victory. The best even his defenders can claim is that the legislation is an 'historic' start. What does that tell us?

It tells us what we already know. He's a clueless empty suit with great teeth who smiles a lot and smokes.

that something like 57% disapprove of Obama's handling of healthcare according to an NBC poll, there will probably be more house members coming out against it. I mean voting against it at this point would seem to be a better bet for them than voting for it.

Run down the list of scams and ripoffs and bait-and-switch con games in the HCR bill, and you realize it will actually make things worse.

How so?

[1] The exchanges are so small -- only 3 million people -- that they will have less bargaining power with insurers than other groups. Consequently, people dumped into the exchanges will pay more more for health insurance than people in regular insurance plans.

[2] As the video points out, insurers only get fined $100 a day for refusing to cover people with chronic illnesses. That's a bargain for insurers, who are sure to dump people with expensive medical conditions by the millions.

[3] Those 15 million people who are supposed to get picked up by medicaid? Wake up, folks, almost all of those people have jobs and own cars, and the stringent eligibility requirements for state medicaid programs insures that they won't qualify. Those 15 million sick people who can't afford insurance are going on medicaid -- they're going onto the streets, where they'll curl up on steam grates and die slowly of their chronic illnesses. Consider by way of example the elgibility requirements of a typical state medicaid program: if you own a home, you don't qualify. If you have more than $4000 in assets, you don't qualify. Medicaid is designed for the very bottom rung of society, people who are on welfare or homeless. It was never designed to cover the middle class people who can't afford skyrocketing insurance premiums, and in any case the states are already slashing medicaid right and left because almost all the states in America are insolvent and bleeding red ink.

[6] Lastly, the HCR bill allows recission under another name. Merely by reclassifying it as fraud, the insurance companies can continue to dump people from the insurance rolls. Of course people thus dumped can sue...but they can sue now, and what good does that do? By the time you win the lawsuit, you're dead from your illness.

This HCR bill is a nightmare. It's going to make everything worse.

Five years from now, everyone who today cheers themselves hoarse for the current HCR bill will be sitting with head in hands moaning, "Why did I ever support that goddamn disaster of a health care reform bill?" Exactly the way all those millions of people who cheered on the invasion of Iraq in 2003 today sit glumly watching news reports of the latest U.S. troops blown up by IEDs in yet another insurgent attack.

Thank you for providing that summary. This thing really is a hideous monster.

Re # 6: They already do that, they call it "post-claims underwriting." And yes, like you said, there is nothing the insured (or "thought-he-was-insured") person can do about it except sue the SOBs, and how many people have the time and resources to do that? How many even know they can? WHY should you have to sue your insurance provider to get the care you paid for?? It's insane.

The only thing that's more insane is people acting like the "no dropping you if you get sick" and "preexisting condition" elements of this POS bill are going to do anything to fix this. The bill's supporters keep touting these provisions as their reason to back the bill, but they are hollow and toothless provisions.

What's also unprecedented -- and utterly horrifying, or should be, to anyone who calls themselves a "liberal" or "Democrat-- is the government using its might to force people to buy a consumer product that they hate and don't want.

read some of the comments on these recent threads: it will be historical for Obama to get anything, anything at all passed, passing this will give Obama needed political power, this lousy bill must be passed.....for Obama.

It's as though they have absolutely no clue what the topic of this bill is, or how negatively it will impact the lives of the majority of Americans.

Let Obama find his historical powers in making good policy to get the troops home from the ME, those green energy jobs that are sending 80% of the jobs and hundreds of millions of the stimulus dollars to China back in the USA, regulate Wall St, the banks, the insurance industies, etc....you know, something that's actually GOOD for this country.

... there are sufficient D's in bargaining postures, and sufficient carrots/sticks in leadership's treasury/armory, that it will pass the House.

Most risk of non-passage falls in the parliamentary gymnastics department, and even if I did know anything about that I wouldn't venture an assessment, as both opposing camps know more and have gamed it out beyond the limits of my imagination.

*[Though Sadly Unversed In Such Matters -- as no less authority than BTD himself assures me I am -- I could not resist speculating on what one might say IF one had a deeper grasp of the sausage-making process.]

Second: let's run down the answer to your question in cold sobering detail.

Whose life does the current HCR bill affect negatively?

If you're middle class, making between $35,000 and $75,000 per year, the CBO (that's the Congressional Budget Office, a non-partisan accounting agency) says that the current HCR bill affect your life negatively. The CBO projects that within 5 years after passage of the current HCR bill, 1 out of every 3 families making between $35K and $75K will get clobbered by the "cadillac tax" in this bill. This means that people who already have decent insurance will lose a substantial chunk of their income through the cadillac tax -- at the very time when health insurance premiums are skyrocketing because the giant insurance cartels have now got a captive market for their unaffordable monopoly, enforced by the power of the U.S. government.

The CBO analysis found that in the non-group market, average premiums would be "about 10 to 13 percent higher in 2016...than under current law." The result would be a premium increase of $300 per year for individuals and $2,100 for families.

CBO also found that the "user fees"-i.e., taxes-imposed in the Senate bill "would be largely passed through to customers in the form of higher premiums for private coverage."

To learn more about the giant corrupt collusive cartels that conspire to drive up U.S. health care costs to 700% to 10,000% of what the exact same health care service costs in Europe, see "Experts Warn of Medical Industry Cartels' Power," San Francisco Chronicle, 21 February 2010. As an example of the kind of grotesque cartel monopoly power doctor-hospital-insurer-medical-devicemakers enjoy in America, compare the cost of a simple CAT scan in America to the cost of the exact same CAT scan with the exact same machine in France or Germany. A CAT scan costs between $1400 and $3230 in America, whereas in France it costs $40 and in Germany the exact same CAT scan costs $35. That's not due to a "fragmented market" or "bureaucratic inefficiencies," that's due to pure corrupt collusion and greed among health care providers who collude with one another at every level of the American health care system, from the doctor who overcharges you $150 for a simple doctor's visit (compared to $30 in Germany for the exact same routine doctor's visit) to the simple chem/CBC blood panel that costs $500 in America but costs $15 in France to the insurance whose premiums skyrocket by 76% per year (compared to a modest 3% annual cost increase in single-payer countries like Canada or France or Germany) to the medical devicemakers who manufacture disposable surgical instruments like plastic retractors (no more complex than a spork) for $12 but charge $1200 to the patient getting an operation.

That's not "inefficiency," it's pure naked greed and corrupt collusion among members of an anti-competitive medical-industrial cartel. Every time someone gets a CAT scan in America, the group of doctors who own that CAT scanner high-five each other and shout, "Bugatti Veyron, baby! Month-long Acapulco vacation! Penthouse on Park Avenue!" because of the grotesque amount of greedy overchaged profit they're making on each and every scan -- $2980 proft on every single CAT scan.

The planned spike in health insurance rates by Anthem Blue Cross in California is just the tip of a Titanic-size iceberg of exorbitant price increases, secret pricing and consolidation not only by insurers - but by the hospitals, doctors and medical devicemakers that send the bills to the insurers.

Insurers, who strike deals with providers, pass the bills on to patients, businesses and governments. The nation is fast being bankrupted by a medical money machine that costs $2.5 trillion a year and takes more than $1 of every $6 that Americans earn.

"It's an insider's game in health care," said Jeffrey Lerner, president and chief executive of the ECRI Institute, a nonprofit that researches medical practices.

While the Anthem case has raised a political storm, the underlying surge in costs gets far less scrutiny. But each sector of the health industry points fingers at the other for driving up prices, and all are raking in money.

Insurers blame hospitals and doctors, doctors blame insurers, and hospitals blame doctors and medical devicemakers in what academics call an inscrutable medical-industrial complex that rivals anything the defense industry ever invented. All these groups are combining into what many experts describe as cartels.

Many industry insiders are afraid to speak on the record for fear of antagonizing the medical groups they rely on for their survival. Contracting practices are draped in secrecy. Prices are almost impossible to obtain because of "confidentiality agreements" among hospitals, physician groups, insurers and devicemakers who do not want their markups exposed to competition or public scrutiny.

(San Francisco Chronicle investigative story, op. cit.)

And the current health care bill does nothing, aboslutely nothing, to break up these corrupt collusive anti-competitive medical-industrial cartels that monopolize markets and jack up prices -- and they jack up prices not just by 20% or %70, but by 500% and 700% and 10,000%. That's insane. No society can afford that. The current health care bill locks in place a corrupt collusive anti-competitive cartel system that's driving costs so high so fast, there isn't enough money in their entire universe to pay for the stratospheric health care costs required to buy those vacations homes for all those doctors and those St. Mortiz skiing vacations for all those 20-million-dollar-a-year health insurance CEOs and those sports cars driven by those $150,000-a-year ICU nurses and the condos bought by those $59,000-a-year radiological technicians (who are nothing but glorified button-pushers with a 2-year A.S. degree).

In fact, the current HCR bill makes these medical cartels more powerful. It makes everything worse. Because now the HCR bill requires everyone above 150% of poverty level to buy insurance from these corrupt collusive anti-competitive cartels, vastly increasing their market power.

Christina Bernstein, a medical-device engineer and independent sales representative based in San Francisco, sells disposable surgical tools made mostly out of plastic that she estimates are manufactured for about $40 each. These are marked up and sold to hospitals for as much as $350, she said, for a single use in a surgery on a patient.

"But if you were to get a detailed bill of what the hospital was charging the insurance company for the insured patient, those things get marked up to something like $1,200," Bernstein said. "It's ridiculous. There's no open competition."

(San Francisco Chronicle investigative report, op. cit.)

By conferring a regulatory monopoly on each state, the McCarran-Ferguson Act ends up protecting insurance companies from interstate competition--residents may not buy policies from insurers located outside their state. Because health insurers are insulated against out-of-state competition, state insurance commissions and legislatures feel free to impose coverage mandates that significantly drive up policy premiums.

The proliferation of hundreds of state health insurance mandates and regulations also serves as effective barriers to entry for potential competitors. An insurance company trying to enter a new market would have to meet all of a state's mandates. At the same time, the company would have less negotiating clout with doctors and hospitals, which means it would have to pay providers more for their services. In addition, a new entrant trying to attract policyholders would have to charge lower premiums than the incumbent companies to gain a foothold. So a would-be competitor must pay more to health care providers while earning less from policyholders.

Given these mandated barriers, insurance companies have found that the easiest way to enter to a new state is to buy another company that is already operating in the market. It is this dynamic that is driving the trend toward consolidation in health insurance markets.

This isn't happening by "bad luck." A CAT scan doesn't cost $3230 in America but $40 in Germany because of some freak natural disaster, like a storm or a plague of locusts. American health care costs continue to skyrocket because of corrupt collusion and anti-competitive coercion by interlocking cartels of greedy doctors and greedy hospitals and greedy insurance companies and greedy medical devicemakers who act as colluding monopolies to drive prices up into the stratosphere.

And the current HCR bill not only locks that corrupt monopoly system in place, it makes it worse by backing it with the full power of the federal government to punish anyone who refuses to pay whatever those corrupt medical cartels charge.

...Patients calling Massachusetts General Hospital--ranked the fifth best in the nation by U.S. News and World Report--were informed that Harvard's massive academic hospital was no longer accepting new patients needing primary care. And that problem isn't limited to Massachusetts General--it's occurring throughout the state. Despite near-universal insurance, oodles of doctors, reams of cash, and no dearth of bright minds, the average person in Massachusetts can't find a new primary care doctor.

The nation soon may face the same fate. To have any hope of meaningful national health reform, therefore, we must address the perverse financial incentives that created and continue to inflame this problem.

Fundamentally, the entire payment model of American health care drives medical centers, doctors, and hospital managers to push for more fancy procedures at the expense of primary care doctors. How'd we get here? Since 1992, Medicare has depended almost entirely on the American Medical Association for guidance on how relative values should be set. In a devastating critique published in the Annals of Internal Medicine, scholars from the Urban Institute and the University of California-San Francisco explained that Medicare uncritically accepted 95 percent of the AMA's recommendations, which are formulated by the group's Relative Value Scale Update Committee, or RUC.

Of the committee's 29 members, 23 are appointed from subspecialties like cardiology and dermatology. Just three represent primary care, even though half of all Medicare dollars are spent on face-to-face encounters. Their meetings are closed to uninvited observers. Unsurprisingly, over time, the relative values of various procedures far outpaced face-to-face "evaluation and management." In 2000, for example, the RUC recommended relative value increases in 469 specialty procedure codes but made no change in codes related to evaluation and management--which are used by primary care doctors for outpatient visits for physicals, back pain, headaches, and so on.

It's not just coincidence or allegedly superhuman skill that M.D.s in America make a median income of $200,000 a year, 2x to 5x what doctors in Europe make -- it's due to the corrupt anti-competitive actions of the medical cartel, specifically, in this case, the AMA, which artificially restricts the number of entrants to medical school each year in order to artificially reduce the number of doctors in America and keep physicians' salaries sky-high.

The current HCR bill does nothing, absolutely nothing, to attack these cartels and monopolies that are jacking up the cost of medical care in America to new record highs every month. On the contrary -- the HCR bill makes everything worse, by cementing the power of these giant corrupt medical cartels by threatening anyone who doesn't buy insurance with the full force of the IRS and the federal government.

So middle-class families throughout America are going to be clobbered by the HCR bill. Their premiums will skyrocket. If you have insurance, your employer is shifting the burden of paying for insurance onto employees as fast as possible, so you're going to see not only your health insurance premiums skyrocket as a result of this bill, the base amount you have to co-pay as part of the insurance you get through your job will skyrocket too, because employers can't afford to pay for these double-digit health insurance premium hikes.

So if you have insurance, you'll soon lose it, because you won't be able to pay for it. And then the IRS will step in and crush you with a whopping bill because you can't afford health insurance. That's in you're a member of the middle class, making $35,000 to $75,000 a year.

Whose life does the current HCR bill affect negatively?

Not just the middle class, but also people in the bottom income quartile.

The current HCR bill expands medicaid, putting 15 million new people (all of whom make less than $25,000 per year) on medicaid.

But states are making deep cuts to medicaid because most states in the U.S. are now insolvent:

US states are imposing major cuts to Medicaid, the health insurance program for low income Americans jointly funded with the federal government. The cuts are being enacted in response to huge budget deficits in states throughout the country and a sharp increase in enrollment fuelled by the unemployment crisis.

Cuts in Medicaid services are a critical component of the attempts by the US corporate and financial elite, led by the Obama administration, to slash government health care costs and reduce care. On Thursday, Obama established a bipartisan panel whose central purpose will be to find ways to decrease spending on government health care and pension programs, including Medicaid.

Some versions of the Democrats' health care overhaul proposals include an expansion of Medicaid eligibility, but without full support for state governments. This will translate into further cuts to services and ensure that larger numbers of Americans have access only to the most limited and inadequate health care coverage, while the wealthy continue to enjoy the best care money can buy.

Enrollment in Medicaid increased by 3.3 million between June 2008 and June 2009 to nearly 47 million cases, according to a study released Thursday by the Kaiser Family Foundation. Caseloads increased in every US state. In thirteen states, enrollment shot up by more than 10 percent. According to a new study by Families USA, for every 1 percentage point rise in the US unemployment rate, 1 million people become eligible for Medicaid and related programs.

With Medicaid already consuming about a fifth of most state budgets--the same as the average outlay for education--both Democrat and Republican governors and lawmakers throughout the country are insisting on deep cuts in the services provided to Medicaid recipients.

"Facing relentless fiscal pressure and exploding demand for government health care, virtually every state is making or considering substantial cuts in Medicaid, even as Democrats push to add 15 million people to the rolls. "

(op. cit.)

So not only will the middle class get clobbered by the current HCR bill, the poorest of the poor will get hammered too, left to die on the streets as states cut medicaid in a frantic bid to stem the tsunami of red ink that's drowning state budgets across the country.

But that's just the start. Because the "cadillac tax" makes the current HCR bill a hidden time bomb -- as health care insurance costs rise and rise and rise, that cadillac tax will gobble up more and more of the average middle class worker's income as each year passes. Soon, the middle class will reach the breaking point, where they either have to sell their homes or give up insurance they can't afford (and face a still IRS fine for doing so).

There is a middle-class tax time bomb ticking in the Senate's version of President Obama's effort to reform health care.

The bill that passed the Senate with such fanfare on Christmas Eve would impose a confiscatory 40 percent excise tax on so-called Cadillac health plans, which are popularly viewed as over-the-top plans held only by the very wealthy. In fact, it's a tax that in a few years will hammer millions of middle-class policyholders, forcing them to scale back their access to medical care.

Which is exactly what the tax is designed to do.

The tax would kick in on plans exceeding $23,000 annually for family coverage and $8,500 for individuals, starting in 2013. In the first year it would affect relatively few people in the middle class. But because of the steadily rising costs of health care in the U.S., more and more plans would reach the taxation threshold each year.

Within three years of its implementation, according to the Congressional Budget Office, the tax would apply to nearly 20 percent of all workers with employer-provided health coverage in the country, affecting some 31 million people. Within six years, according to Congress's Joint Committee on Taxation, the tax would reach a fifth of all households earning between $50,000 and $75,000 annually. Those families can hardly be considered very wealthy.

Proponents say the tax will raise nearly $150 billion over 10 years, but there's a catch. It's not expected to raise this money directly. The dirty little secret behind this onerous tax is that no one expects very many people to pay it. The idea is that rather than fork over 40 percent in taxes on the amount by which policies exceed the threshold, employers (and individuals who purchase health insurance on their own) will have little choice but to ratchet down the quality of their health plans.

These lower-value plans would have higher out-of-pocket costs, thus increasing the very things that are so maddening to so many policyholders right now: higher and higher co-payments, soaring deductibles and so forth. (..)

Proponents say this is a terrific way to hold down health care costs. If policyholders have to pay more out of their own pockets, they will be more careful -- that is to say, more reluctant -- to access health services. On the other hand, people with very serious illnesses will be saddled with much higher out-of-pocket costs. And a reluctance to seek treatment for something that might seem relatively minor at first could well have terrible (and terribly expensive) consequences in the long run.

(op. cit.)

So let's sum up:

The current HCR bill hurts the middle class. It hurts poor people. It gives the corrupt collusive doctor-hospital-insurer-medical-devicemaker cartels greater power, backed by the government. The current HCR bill does nothing to control costs. The current HCR dumps 15 million onto state medicaid at the very time states are slashing medicaid benefits, so those 15 million people won't get any health care, they'll get a cardboard box to sleep in on the sidewalk as they die from chronic untreated illnesses.